Electroacupuncture for residual insomnia associated with major depressive disorder: a randomized controlled trial.
Yeung WF, Chung KF, Tso KC, Zhang SP, Zhang ZJ, Ho LM.
STUDY OBJECTIVES:
To evaluate the efficacy and safety of electroacupuncture as an additional treatment for residual insomnia associated with major depressive disorder (MDD).
DESIGN:Randomized, placebo-controlled.
SETTING:A psychiatric outpatient clinic.
PARTICIPANTS:78 Chinese patients with DSM-IV-diagnosed MDD, insomnia complaint, a Hamilton Rating Scale for Depression (HDRS(17)) score ≤ 18, and fixed antidepressant dosage.
INTERVENTION:Electroacupuncture, minimal acupuncture (superficial needling at non-acupuncture points), or noninvasive placebo acupuncture 3 sessions weekly for 3 weeks.
MEASUREMENTS AND RESULTS:
Insomnia Severity Index (ISI), Pittsburgh Sleep Quality Index (PSQI), HDRS(17), 1 week sleep diaries, and 3 day actigraphy were administered at baseline, 1 week post-treatment, and 4 week post-treatment. There was significant group by time interaction in ISI, PSQI, and sleep diary-derived sleep efficiency (mixed-effects models, P = 0.04, P = 0.03, and P = 0.01, respectively). Post hoc pairwise comparisons revealed that electroacupuncture and minimal acupuncture were more efficacious than placebo acupuncture in ISI and PSQI at 1 week and 4 week post-treatment. Minimal acupuncture resulted in greater improvement in sleep diary-derived sleep efficiency than placebo acupuncture at 1 week post-treatment. There was no significant between-group difference in actigraphy measures, depressive symptoms, daily functioning, and hypnotic consumption, and no difference in any measures between electroacupuncture and minimal acupuncture.
CONCLUSION:
Compared with placebo acupuncture, electroacupuncture and minimal acupuncture resulted in greater improvement in subjective sleep measures at 1 week and 4 week post-treatment. No significant difference was found between electroacupuncture and minimal acupuncture, suggesting that the observed differences could be due to nonspecific effects of needling, regardless of whether it is done according to traditional Chinese medicine theory. CLINICAL TRIAL INFORMATION: Acupuncture for Residual Insomnia Associated with Major Depressive Disorder; Registration #NCT00838994; URL - http://clinicaltrials.gov/ct2/show/NCT00838994?term = NCT00838994&rank = 1 CITATION: Yeung WF; Chung KF; Tso KC; Zhang SP; Zhang ZJ; Ho LM. Electroacupuncture for residual insomnia associated with major depressive disorder: a randomized controlled trial. SLEEP 2011;34(6):807-815.
Sleep. 2011 Jun 1;34(6):807-15.
Acupuncture improves health-related quality-of-life (HRQoL) and sleep in women with breast cancer and hot flushes.
Frisk J, Källström AC, Wall N, Fredrikson M, Hammar M.
Source
Obstetrics and Gynaecology, Faculty of Health Sciences, Linköping University, University Hospital, 581 85, Linköping, Sweden, Jessica.frisk@liu.se.
Abstract
PURPOSE:
Evaluate effects of electro-acupuncture (EA) and hormone therapy (HT) on health-related quality-of-life (HRQoL) and sleep in breast cancer survivors with vasomotor symptoms.
METHODS:
Forty-five women, randomized to EA (n = 27) for 12 weeks or HT (n = 18) for 24 months, were followed for up to 2 years. Distress caused by, and numbers of, hot flushes, hours slept and times woken up/night, Psychological and General Well-being Index (PGWB) and Women's Health Questionnaire (WHQ) were registered before and during treatment and at 6, 9, 12, 18 and 24 months after start of treatment.
RESULTS:
After 12 weeks of EA (n = 19), WHQ improved from 0.32 (IQR 0.23-0.53) at baseline to 0.24 (IQR 0.12-0.39; p < 0.001) and PGWB from 78 (IQR 53-89) to 79 (IQR 68-93; p = 0.002). All sleep parameters improved and Hot Flush Score (HFS) decreased by 80%. At 12 months, WHQ, PGWB and all sleep parameters remained significantly improved (n = 14) and HFS decreased by 65%. After 12 weeks of HT (n = 18), WHQ improved from 0.29 (IQR 0.15-0.44) at baseline to 0.15 (IQR 0.05-0.22; p = 0.001), PGWB from 75 (IQR 59-88) to 90 (62-97; p = 0.102) and three of five sleep parameters improved.
CONCLUSION:
Both EA and HT increased HRQoL and sleep, probably through decreasing numbers of and distress by hot flushes. Although flushes decreased less in the EA group than in the HT group, HRQoL improved at least to the same extent maybe due to other effects of EA, not induced by HT, e.g. on anxiety, vitality and sleep, supported by subscale analyses. EA should be further evaluated as treatment for women with breast cancer and climacteric complaints, since HT no longer can be recommended for these women.
Support Care Cancer.2011 Apr 6.
Acupuncture for Treatment of Insomnia in Patients With Traumatic Brain Injury: A Pilot Intervention Study.
Zollman FS, Larson EB, Wasek-Throm LK, Cyborski CM, Bode RK.
Departments of Physical Medicine and Rehabilitation & Neurology, Northwestern University Feinberg School of Medicine (Dr Zollman), Department of Physical Medicine and Rehabilitation, Northwestern University Feinberg School of Medicine (Dr Larson), Department of Physical Medicine and Rehabilitation, The Rehabilitation Institute of Chicago (Ms Wasek), Department of Physical Medicine and Rehabilitation, Northwestern University Feinberg School of Medicine (Dr Cyborski), Northwestern University, Northwestern University Feinberg School of Medicine, Chicago, Illinois (Dr Bode).
OBJECTIVES:To assess the efficacy of acupuncture in treating insomnia in traumatic brain injury (TBI) survivors as compared to medication, to determine whether acupuncture has fewer cognitive and affective adverse effects than does medication.
PARTICIPANTS:Twenty-four adult TBI survivors, randomized to acupuncture or control arms.
SETTING:Outpatient rehabilitation clinic.
MEASURES:Insomnia Severity Index (degree of insomnia); actigraphy (sleep time); Hamilton Depression Rating Scale (depression); Repeatable Battery for the Assessment of Neuropsychological Status and Paced Auditory Serial Addition Test (cognitive function) administered at baseline and postintervention.
RESULTS:Sleep time did not differ between the treatment and control groups after intervention, whereas cognition improved in the former but not the latter.
CONCLUSION:Acupuncture has a beneficial effect on perception of sleep or sleep quality and on cognition in our small sample of patients with TBI. Further studies of this treatment modality are warranted to validate these findings and to explore factors that contribute to treatment efficacy.
J Head Trauma Rehabil.2011 Mar 7.
